Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
21-Plex Pcr and Antifungal Susceptibility Aspects of Fungemia Agents in Pediatric Patients With Hematological Malignancies: A Single-Center Experience Publisher



Asnafi AA1 ; Moslem M2, 3 ; Sarbandi F1, 4 ; Khodavaisy S5, 6 ; Kiasat N3, 7
Authors
Show Affiliations
Authors Affiliations
  1. 1. Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  2. 2. Department of Pharmacognosy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  3. 3. Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  4. 4. Department of Pediatrics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  5. 5. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Source: Jundishapur Journal of Microbiology Published:2024


Abstract

Background: Fungemia is a life-threatening infection which requires an early diagnosis and use of appropriate antifungal agents to be treated effectively. Objectives: Here, we describe the clinical-epidemiological characteristics as well as the antifungal susceptibility patterns of fungal agents in pediatric patients with malignancy. Methods: Two hundred and five blood samples were cultured to detect infection. The infectious agents were identified by phenotypic methods and 21-plex PCR. Antifungal susceptibility testing was performed using an E-test and disc diffusion test based on CLSI standard M27-A3 protocol. The demographic data of the studied population were extracted and analyzed. Results: In total, 36 out of 205 patients (17.6%) were positive for fungemia. 32 (88.9%) and 4 (11.1%) cases were found to be caused by Candida and Rhodotorula species, respectively. The patient's age ranged from 1 to 14 years. The majority of the patients were males (28; 77.8%) and were hospitalized for more than seven days (33; 91.7%). Non-Candida albicans species were the most common agents of fungemia (27 patients; 75%), with C. parapsilosis (77.8 %) as the dominant agent. Fever, central venous catheters, and broad-spectrum antibiotic therapy were observed in all cases. Itraconazole resistance was observed in a species of C. orthopsilosis. While the Candida isolates were susceptible to fluconazole, C. parapsilosis showed a significant rate of resistance to caspofungin, followed by itraconazole and amphotericin B. Overall, no mortality was reported among the fungemia cases. Conclusions: This study identified acute lymphoblastic leukemia (ALL) as a hematologic malignancy associated with fungemia. The increase of non-C. albicans species, including C. parapsilosis, along with reduced susceptibility to antifungal drugs, maybe a warning sign in pediatric patients with malignancies. Furthermore, fluconazole was the most effective antifungal agent against the recovered isolates. Therefore, the best strategy for the management of fungemia is to increase knowledge based on local epidemiological and mycological characteristics. © 2024, Asnafi et al.
Related Docs
View other Related Docs
1. Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates, Frontiers in Cellular and Infection Microbiology (2020)
2. Epidemiology of Yeast Species Causing Bloodstream Infection in Tehran, Iran (2015-2017); Superiority of 21-Plex Pcr Over the Vitek 2 System for Yeast Identification, Journal of Medical Microbiology (2020)
3. The Relationship Between Biofilm Formation and Mortality in Patients With Candida Tropicalis Candidemia, Microbial Pathogenesis (2021)
4. Candidemia in Children Caused by Uncommon Species of Candida, Archives of Pediatric Infectious Diseases (2018)
5. Incidence and Spectrum of Yeast Species Isolated From the Oral Cavity of Iranian Patients Suffering From Hematological Malignancies, Journal of Oral Microbiology (2019)
6. Candidemia and Its Risk Factors in Neonates and Children, Archives of Pediatric Infectious Diseases (2020)
7. M Eyerozyma Guilliermondii Species Complex: Review of Current Epidemiology, Antifungal Resistance, and Mechanisms, Brazilian Journal of Microbiology (2022)
8. Epidemiological Features of Nosocomial Candidaemia in Neonates, Infants and Children: A Multicentre Study in Iran, Mycoses (2020)
Experts (# of related papers)
View all Related Experts
Sadegh Khodavaisy (7)
Mohammadreza Salehi (6)
Other Related Docs
9. Virulence Factors and Azole-Resistant Mechanism of Candida Tropicalis Isolated From Candidemia, Mycopathologia (2021)
10. Identification of Uncommon Oral Yeasts From Cancer Patients by Maldi-Tof Mass Spectrometry, BMC Infectious Diseases (2018)
11. Port Implantation-Related Bloodstream Infection Caused by Wickerhamomyces Myanmarensis: A Case Report, Current Medical Mycology (2023)
12. Low Level of Antifungal Resistance of Candida Glabrata Blood Isolates in Turkey: Fluconazole Minimum Inhibitory Concentration and Fks Mutations Can Predict Therapeutic Failure, Mycoses (2020)
13. Five-Year Laboratory-Based Study of Candida Albicans Versus Non-Albicans Candida Species at a Tertiary Pediatric Care Hospital in Iran, Kuwait Medical Journal (2020)
14. Frequency of Uncommon Clinical Yeast Species Confirmed by Its-Sequencing, Archives of Clinical Infectious Diseases (2019)
15. Species Distribution and Antifungal Susceptibility Profile of Candida Isolates From Blood and Other Normally Sterile Foci From Pediatric Icu Patients in Tehran, Iran, Medical Mycology (2020)